Provider Demographics
NPI:1861972887
Name:RUIZ, DANIEL B (PTA)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:B
Last Name:RUIZ
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 OLIVIA DL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-4307
Mailing Address - Country:US
Mailing Address - Phone:210-438-3182
Mailing Address - Fax:
Practice Address - Street 1:384 HARMONY HLS
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78070-2107
Practice Address - Country:US
Practice Address - Phone:830-438-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2041846225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant